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NPI Code Detail

MEDICARE: ETHAN W SEYMOUR DO

MEDICARE: ETHAN W SEYMOUR DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianDR.0072399CO

General Provider Information

NPI Number : 1346983517
Entity Type Code : Individual
Provider Name (Legal Business Name) : ETHAN W SEYMOUR DO
Provider Business Mailing Address
First Line : 2698 PATTERSON RD STE 100
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-8211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2698 PATTERSON RD STE 100
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-8211
Country : US
Telephone Number : 978-298-2195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2022
Last Update Date : 09/08/2025

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Directions to “ ETHAN W SEYMOUR DO” Practice Location

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